Validation of the Hamilton Depression rating scale and Montgommery and Asberg Rating Scales in terms of AGECAT depression cases

Objective. To validate the Hamilton Depression (17) and Montgommery and Asb erg Depression Scales as research instruments in older depressed community residents. Design. External validation against GMS/AGECAT case level in the recruitmen t of older community residents for an antidepressant trial. Analyses. Receiver operator curves were generated for each rating scale, us ing GMS/AGECAT case level in external criterion. The sensitivity, specifici ty, positive and negative predictive values of both rating instruments were examined in the whole sample and age and gender subgroups. MADRS and HAM-D cut-off scores differentiating GMS/AGECAT cases from subcases were identif ied. Results. HAM-D cut-off score of 16 and MADRS score of 21 were identified as differentiating case from sub-case. Diagnostic accuracy of both instrument s was good, reflecting good sensitivity and specificity across both genders and sub-age groups. Conclusions. Both scales performed well in this population. These scores pr ovide researchers with externally validated and clinically relevant cut-off scores in designing trials in the management of older depressed community residents. Copyright (C) 2000 John Wiley & Sons, Ltd.